RU2847220C1 - Device for delivering intraocular lens - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: ophthalmic surgical device may comprise a tip having a delivery lumen, an implant cell connected to the tip, and an implant in the implant cell. Implant may comprise an optical body, a front haptic element and a back haptic element. In some examples, the implant may be an intraocular lens. Device may further comprise an actuator comprising a housing and a plunger located in the housing, and a front deflection arm configured to deflect the anterior haptic element in the implant cell. Plunger may be configured to advance the optical body from the implant cell into the delivery lumen after the front deflecting lever straightens the front haptic element.

EFFECT: using the given group of inventions enables improving the intraocular lens delivery system.

18 cl, 27 dwg

Description

[0001] This application claims the benefit of priority to U.S. Provisional Patent Application Serial No. 63/120,955, entitled "HAPTIC MANAGEMENT FOR DELIVERY OF INTRAOCULAR IMPLANTS," filed December 3, 2020, and assigned to Jestwin Edwin Lee, IV, Kate Jensen, Anubhav Chauhan, Todd Taber, Yinghui Wu, and Saumya Dilip Yadav, which is incorporated herein by reference in its entirety as if fully set forth herein.

AREA OF TECHNOLOGY

[0002] The present invention, as set forth in the appended claims, relates generally to ocular surgery. More particularly, but without limitation, the claimed subject matter relates to systems, devices, and methods for inserting an implant (intraocular lens) into the eye.

LEVEL OF TECHNOLOGY

The human eye can suffer from a number of conditions, causing anything from mild impairment to complete vision loss. While contact lenses and glasses can compensate for some ailments, others may require ophthalmic surgery. In some cases, implants may be helpful or desirable. For example, an intraocular lens can replace a clouded natural lens in the eye to improve vision.

[0004] While the benefits of intraocular lenses and other implants are known, improvements in delivery systems, components, and processes continue to improve outcomes and benefit patients.

ESSENCE OF THE INVENTION

[0005] New and suitable systems, devices and methods for ophthalmic surgery are set forth in the appended claims. Illustrative embodiments are also provided to enable a person skilled in the art to make and use the claimed subject matter of the invention.

[0006] For example, some embodiments may include or consist essentially of a device for delivering an intraocular lens that comprises at least one device configured to actively manipulate at least one haptic element associated with the lens prior to delivery. In more specific embodiments, one or more devices may be configured to actively straighten the anterior haptic element, the posterior haptic element, or both.

[0007] In some embodiments, the device may comprise a front deflection lever configured to actively straighten the front haptic element. For example, the front deflection lever may be advanced forward to engage and push the front haptic element forward to place it in a straightened orientation. In some embodiments, the front deflection lever may form the bottom wall of the delivery channel. Then, a plunger may be used to engage the optical portion of the lens and advance the lens forward. When the plunger advances the lens, the second device may interact with the rear haptic element to passively straighten the rear haptic element. For example, the second device may comprise a portion of the side wall, which may be formed as a substantially rigid lever configured to engage the rear haptic element. In some embodiments, the front deflection lever and the plunger may be advanced forward together using a single actuator. In other embodiments, the front deflection lever and the plunger may be actuated independently of each other.

[0008] In some embodiments, two movable tilting arms may be provided, each of which may engage with one of the haptic elements. These two arms may extend or move in opposite directions to orient, straighten, or otherwise manipulate the haptic elements. For example, one arm may move forward to straighten the anterior haptic element forward, and the other arm may move in the opposite direction to straighten the posterior haptic element backward, resulting in a straight configuration of the haptic elements suitable for delivery. In some examples, the arms may further form sidewalls, which may help maintain the configuration of the haptic elements, prevent rotation of the optical body, or both. The sidewalls may also define a smaller clearance to maintain the alignment of the lens as it is advanced.

[0009] In some examples, the levers may be actuated by independent rods, pivoting members, or similar elements. In some embodiments, a cam system configured to coordinate the actuation of the levers may be additionally or alternatively provided.

[0010] In some examples, two devices may be formed as part of the inner walls of the delivery device for orienting the haptic elements prior to advancement. The first device may be in the form of a lever with a Y-shaped end for pushing or straightening the anterior haptic element. The second device may comprise a cam with a hook-shaped end that can slide in the opposite direction relative to the first device for straightening the posterior haptic element.

[0011] In general, in some embodiments, an ophthalmic surgery device may comprise a tip having a delivery lumen, an implant (intraocular lens) cell connected to the tip, and an intraocular lens (implant) located in the implant cell. The implant may comprise an optical body, a front haptic element, and a rear haptic element. In some examples, the implant may be an intraocular lens. The device may further comprise an actuator comprising a housing, a plunger located in the housing, and a front deflection lever configured to deflect the front haptic element in the implant cell. The plunger may be configured to advance the optical body from the implant cell into the delivery lumen after the front deflection lever straightens the front haptic element.

[0012] In more specific embodiments, the implant cell may comprise a posterior deflection lever configured to deflect the posterior haptic element of the lens. In some embodiments, the posterior deflection lever may passively deflect the posterior haptic element when the plunger advances the lens. In other embodiments, the posterior deflection lever may be actuated to actively deflect the posterior haptic element. For example, in some embodiments, the posterior deflection lever may actively deflect the posterior haptic element before the plunger advances the lens. In some embodiments, the anterior deflection lever and the posterior deflection lever may be configured to move in opposite directions.

[0013] Additionally or alternatively, in some embodiments, the front deflection arm, the rear deflection arm, or both may form a wall adjacent to the optical body within the implant cell after the front haptic element has been deflected. In some embodiments, the front deflection arm, the rear deflection arm, or both may comprise an end configured to facilitate engagement with the haptic elements. For example, in various embodiments, the front deflection arm and the rear deflection arm may comprise serrated ends, conical ends, rounded ends, curved ends, or some combination thereof.

[0014] In some exemplary embodiments, an ophthalmic surgical device may comprise an implant chamber (intraocular lens) and an implant located in the implant chamber. The implant may comprise an optical body, an anterior haptic element, and a posterior haptic element. The anterior deflection lever may be configured to deflect the anterior haptic element, and the posterior deflection lever may be configured to deflect the posterior haptic element.

[0015] In more specific examples, the implant chamber may comprise a delivery port, the front deflection lever may be configured to move the free end of the front haptic element toward the delivery port, and the rear deflection lever may be configured to move the free end of the rear haptic element away from the delivery port. In some embodiments, a cam configured to translate the front deflection lever and the rear deflection lever may be further provided.

[0016] Methods for ejecting a lens from a surgical delivery system may include providing a lens in an implant cell, straightening a front haptic element of the lens with a front deflection lever, advancing the lens from the implant cell toward a delivery lumen with a rigid plunger, fluidly connecting a fluid chamber to an opening in the rigid plunger via a bypass passage, compressing fluid in the fluid chamber to move the fluid through the bypass passage and opening into the delivery lumen, and advancing the lens through the delivery lumen with the fluid.

[0017] Features, elements, and aspects described in the context of some embodiments may also be omitted, combined, or replaced with alternative features. Other features, objectives, advantages, and a preferred method for making and using the claimed subject matter are described in more detail below with reference to the accompanying drawings of illustrative embodiments.

BRIEF DESCRIPTION OF GRAPHIC MATERIALS

[0018] The accompanying drawings illustrate certain objects, advantages, and a preferred method of making and using certain embodiments of the claimed subject matter. Like reference numbers represent like parts in the examples.

[0019] Fig. 1 is a schematic view of an illustrative system for inserting an implant into an eye.

[0020] Fig. 2 is a schematic representation of an example of the system of Fig. 1.

[0021] Fig. 3 is a detailed view of an actuator that may be associated with the system of Fig. 2.

[0022] Fig. 4 is an assembled view of another example of the system of Fig. 1.

[0023] Fig. 5 is a detailed view of the actuator illustrated in Fig. 4.

[0024] Fig. 6 shows an isometric view of the system of Fig. 4 in assembled form.

[0025] Fig. 7 is a side view of the system of Fig. 6.

[0026] Fig. 8 is a front view of the system of Fig. 6.

[0027] Fig. 9 shows a sectional view of the system of Fig. 6

[0028] Fig. 10 is an isometric view of another example of an actuator that may be associated with the system of Fig. 1.

[0029] Fig. 11 shows a rear view of the actuator of Fig. 10.

[0030] Fig. 12 shows a sectional view of the actuator of Fig. 11.

[0031] Fig. 13 is an assembled view of the implant control system illustrated in Fig. 4.

[0032] Fig. 14 is a top view of the implant control system shown in Fig. 13.

[0033] Fig. 15 is an isometric view of another example of an implant control system.

[0034] Fig. 16 is an assembled view of the implant control system shown in Fig. 15.

[0035] Fig. 17 is a bottom view of a base that may be associated with some embodiments of the implant control system shown in Fig. 16.

[0036] Fig. 18 is a top view of the implant control system shown in Fig. 15.

[0037] Fig. 19 is an isometric view of another example of an implant control system.

[0038] Fig. 20 is an isometric view of another example of an implant control system.

[0039] Fig. 21 is an assembled view of the implant control system shown in Fig. 20.

[0040] Fig. 22 is a top view of the implant control system shown in Fig. 21.

[0041] Fig. 23 is an isometric view of another example of an implant control system.

[0042] Fig. 24 is an assembled view of the implant control system shown in Fig. 23.

[0043] Fig. 25 is a top view of the implant control system shown in Fig. 23.

[0044] Figs. 26A-26D are schematic views illustrating an illustrative method for removing an implant from the system of Fig. 1.

[0045] Figs. 27A-27B are schematic views showing an illustrative use of the system of Fig. 1 for inserting an implant into an eye.

DESCRIPTION OF ILLUSTRATIVE IMPLEMENTATION OPTIONS

[0046] The following description of illustrative embodiments provides information that enables one skilled in the art to make and use the subject matter of the invention set forth in the appended claims, but may omit certain details already well known in the art. Accordingly, the following detailed description should be considered illustrative and not limiting.

[0047] Illustrative embodiments may also be described herein with reference to spatial relationships between various elements or to the spatial orientation of various elements depicted in the attached graphics. In general, such relationships or orientations suggest a frame of reference corresponding to or relative to a patient in position to receive an implant. However, as will be appreciated by those skilled in the art, these frames of reference are merely descriptive devices and not strict prescriptions.

[0048] Fig. 1 shows a schematic view of a system 100 that can insert an implant into an eye. In some embodiments, the system 100 may comprise two or more modules that can be configured to be connected and disconnected according to circumstances for storage, assembly, use, and disposal. For example, as illustrated in Fig. 1, some embodiments of the system 100 may include a tip 105, an implant cell 110 connected to the tip 105, and an actuator 115 connected to the implant cell 110. In some embodiments, the system 100 may further comprise a drive module 120 configured to engage with the actuator 115.

[0049] The tip 105 typically comprises a tip adapted for insertion through an incision into the eye. The tip size can be adapted to the surgical requirements and techniques, if necessary. For example, small incisions are generally preferred to reduce or minimize healing time. Incisions less than 3 millimeters may be preferred in some cases, and the tip of the tip 105 may have a width of less than 3 millimeters in some embodiments.

[0050] The implant cell 110 typically represents a wide range of devices that are suitable for storing an implant before delivery to the eye. In some embodiments, the implant cell 110 may additionally or alternatively be configured to prepare the implant for delivery. For example, some embodiments of the implant cell 110 may be configured to be actuated by a surgeon or other operator to prepare the implant for delivery by subsequent action of the actuator 115. In some cases, the implant cell 110 may be configured to actively deform, lengthen, expand, or otherwise manipulate elements of the implant before the implant is advanced into the tip 105. For example, the implant cell 110 may be configured to expand or fuse one or more elements, such as haptic elements of an intraocular lens.

[0051] The actuator 115 is generally configured to advance the implant from the implant cell 110 into the tip 105 and then from the tip 105 through the incision and into the eye.

[0052] The drive module 120 is generally configured to electrically actuate the actuator 115. In some examples, the drive module 120 may be actuated by electrical, mechanical, hydraulic, or pneumatic energy, or combinations thereof, or in some other manner. In some cases, the drive module 120 may be actuated manually. According to other embodiments, the drive module 120 may be an automated system.

[0053] In general, the components of the system 100 may be directly or indirectly connected. For example, the tip 105 may be directly connected to the implant cell 110 and may be indirectly connected to the actuator 115 through the implant cell 110. The connection may include a fluid, mechanical, thermal, electrical, or chemical connection (such as a chemical bond), or some combination of connections in some contexts. For example, the actuator 115 may be mechanically connected to the drive module 120 and may be mechanically or fluidly connected to the implant cell 110. In some embodiments, the components may also be connected due to proximity, being an integral part of a single structure, or being formed from the same piece of material.

[0054] Fig. 2 is a schematic diagram of an example of a system 100 illustrating additional details that may be associated with some embodiments. In the example of Fig. 2, the tip 105 has a delivery lumen 205, and the implant 210 is located within the implant cell 110.

[0055] The actuator 115 of Fig. 2 typically includes a housing 215, a plunger 220 located inside the housing 215, an opening 225 passing through the plunger 220, and an actuator interface 230 configured to connect to the actuator module 120. The plunger 220 typically consists of a substantially rigid material, such as a medical-grade polymer material. A plunger seal 235 may be located inside the housing 215 and connected to the plunger 220. An actuator seal 240 may also be located inside the housing 215. In some embodiments, the actuator module 120 may include a pusher 245 configured to engage with the actuator seal 240 through the actuator interface 230. For example, the drive interface 230 may comprise a slot configured to receive the pusher 245.

[0056] As illustrated in the example of Fig. 2, the actuator seal 240 may be located between the plunger seal 235 and the actuator interface 230, and the fluid chamber 250 may be formed inside the housing 215 between the plunger seal 235 and the actuator seal 240. In the exemplary configuration of Fig. 2, the plunger seal 235 is configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving from the fluid chamber 250 to the opening 225. The actuator seal 240 may also be configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving from the fluid chamber 250 to the actuator interface 230.

[0057] Fig. 3 is a detailed view of the actuator 115 of Fig. 2 illustrating additional details that may be associated with some embodiments. For example, the housing 215 of Fig. 3 further comprises a plunger interface 305 and a bypass channel 310 located between the plunger interface 305 and the actuator interface 230. The bypass channel 310 may take various forms. For example, the bypass channel 310 may comprise a projection in the housing 215, as illustrated in Fig. 3. In other examples, the bypass channel 310 may comprise a groove or recess on the inner surface of the housing 215. In some embodiments, the bypass channel 310 may comprise a plurality of channels. For example, a plurality of channels may be arranged circumferentially around the housing 215 in some embodiments.

[0058] The plunger 220 typically has a first end 315 and a second end 320, wherein the first end 315 is typically located adjacent to the plunger interface 305. The opening 225 typically extends through the plunger 220 in a longitudinal direction from the first end 315 to the second end 320.

[0059] In some embodiments, the actuator 115 may further comprise a tip seal 325 and a bypass seal 330. Each of the tip seals 325 and the bypass seals 330 is typically configured to create a seal between the plunger portion 220 and the housing 215 to substantially prevent fluid from moving past the seal. As illustrated in the example of Fig. 3, one or both of the tip seals 325 and the bypass seal 330 may be annular seals, such as an O-ring located circumferentially around the plunger portion 220. In other examples, an umbrella seal may be suitable. In more specific embodiments, tip seal 325 may be located near first end 315 of plunger 220, and bypass seal 330 may be located near second end 320 of plunger 220.

[0060] The drive interface 230 of Fig. 3 includes a cap 335 and a slot 340. The cap 335 may be connected to the end of the housing 215 to retain the drive seal 240 and other components within the housing 215.

[0061] Fig. 4 shows an assembled view of another example of system 100. As illustrated in the example of Fig. 4, the cell 110 for the implant may include an implant control system 405, a support 410, and a cover 415. In various embodiments, the implant control system 405 may be any of a wide variety of systems, devices, components, or cartridges that are configured to prepare an implant for delivery. The support 410 and the cover 415 may be configured to substantially cover the implant control system 405. The support 410 and the cover 415 may also be configured to be mechanically connected to the tip 105 and the actuator 115.

[0062] The housing 215 of Fig. 4 comprises a hollow cylinder that can receive the plunger 220, the plunger seal 235 and the actuator seal 240. Fig. 4 also illustrates an example of an implant interface 420 that can be connected to the first end 315 of the plunger 220 in some embodiments. In the example of Fig. 4, the plunger 220 and the plunger seal 235 can be inserted into the housing 215, and then a suitable working fluid can be added before inserting the actuator seal 240 and attaching the cap 335 to the housing 215.

[0063] In some examples, an implant (not shown) may be preloaded into the implant control system 405. The implant control system 405 is generally configured to store and manipulate the implant. For example, some embodiments of the implant control system 405 may be configured to orient or fold the implant. In some cases, the implant control system 405 may be configured to fold, tilt, or straighten the haptics of an intraocular lens. In the example of FIG. 4, the implant control system 405 comprises a front tilt lever 425 that may be configured to manipulate the implant within the implant chamber 430 of the implant control system 405. Other examples may additionally or alternatively comprise other suitable mechanisms for manipulating the front tilt lever 425, such as a rotary member, a cap, or a wheel. In the example of FIG. 4 the front deflection lever 425 is configured to provide manual actuation of the implant control system 405.

[0064] Fig. 5 is an isometric view of the actuator 115 of EDtU1092 of Fig. 4 in assembled form. As illustrated in the example of Fig. 5, some embodiments of the plunger interface 305 may include an opening in the housing 215 and one or more locking tabs 505. The implant interface 420 and at least a portion of the plunger 220 may extend through the plunger interface 305. The tip seal 325 of Fig. 5 includes an O-ring seal located around the plunger 220 adjacent the first end 315. As seen in the example of Fig. 5, the opening 225 may form an opening in the first end 315. In some embodiments, the opening may be located centrally through the first end 315, and the implant interface 420 may be connected to the plunger 220 adjacent to the opening in the first end 315. The implant interface 420 may comprise a notch 510, which may be configured to engage with the implant.

[0065] Fig. 6 is an isometric view of the system 100 of Fig. 4 in an assembled form, illustrating additional details that may be associated with some embodiments. As illustrated in the example of Fig. 6, the system 100 may have a thin, elongated shape. In some cases, the actuator 115 may be at least partially inserted into the cell 110 for the implant and secured in position using a locking mechanism 605 adapted to engage with interlocking elements of the actuator 115, such as locking tabs 505. In other examples, the actuator 115 may be secured using other suitable fasteners, an interference fit, or a thermal or chemical bond.

[0066] As illustrated in the example of Fig. 6, some embodiments of the tip 105 may comprise an insertion tip 610 and a depth limiting element 615. The insertion tip 610 may be adapted to minimize shear forces during incision. In some examples, the insertion tip 610 may be beveled or angled. The depth limiting element 615 may comprise a flared portion adapted to contact the eye around the incision to limit the penetration depth of the insertion tip 610.

[0067] Some embodiments of the system 100 may further include various ergonomic features. In Fig. 6, for example, the cover 415 of the implant compartment 110 comprises a textured portion 620. The textured portion 620 of Fig. 6 has a shallow recess formed in the cover 415 to accommodate, for example, one or more fingers of an operator. The textured portion 620 may further have a textured surface, which may improve grip and control over the system 100.

[0068] Fig. 7 is a side view of the system 100 of Fig. 6 illustrating additional details that may be associated with some embodiments. As illustrated in the example of Fig. 7, the support 410 may have a raised portion 705 similar to the raised portion 620.

[0069] Fig. 8 is a front view of the system 100 of Fig. 6. As illustrated in Fig. 8, the insertion tip 610 may have a round profile, and the depth limiting member 615 may have an elliptical profile. The insertion tip 610 and the depth limiting member 615 may be concentric in some embodiments, as illustrated in the example of Fig. 8.

[0070] Fig. 9 is a sectional view of the system 100 of Fig. 8 along line 9-9 illustrating additional details that may be associated with some embodiments. In the example of Fig. 9, the tip 105 is connected to the cell 110 for the implant and the actuator 115 is connected to the cell 110 for the implant. The plunger 220 is located inside the housing 215, and the opening 225 passes through the plunger 220 between the first end 315 and the second end 320. The plunger seal 235 may be located inside the housing 215 and connected to the second end 320 of the plunger 220.

[0071] The actuator seal 240 may be located between the plunger seal 235 and the actuator interface 230, and the fluid chamber 250 may be formed within the housing 215 between the plunger seal 235 and the actuator seal 240. In the exemplary configuration of Fig. 9, the plunger seal 235 is configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving from the fluid chamber 250 to the opening 225. The actuator seal 240 may also be configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving from the fluid chamber 250 to the actuator interface 230.

[0072] The bypass channel 310 may be located between the plunger interface 305 and the actuator interface 230. The bypass channel 310 of Fig. 9 comprises a recess on the inner surface of the housing 215.

[0073] As illustrated in Fig. 9, some embodiments of the implant control system 405 may comprise an implant chamber 905 that may provide a path for fluid between the opening 225 and the delivery lumen 205. The implant chamber 905 may also be configured to accommodate a portion of the plunger 220, including the implant interface 420 in some embodiments.

[0074] The example configuration of Fig. 9 is generally suitable for storing an implant (not shown) prior to delivery. More specifically, the implant may be stored in the implant chamber 905. The plunger seal 235 and the actuator seal 240 may be positioned in a first position, wherein the plunger seal 235 fluidly isolates the opening 225 and the bypass channel 310 from the fluid chamber 250, allowing a suitable working fluid to be stored in the fluid chamber 250. Suitable working fluids may include, but are not limited to, a liquid such as a saline solution or a viscous lubricant with non-Newtonian properties.

[0075] Fig. 10 is an isometric view of another example of actuator 115 illustrating additional details that may be associated with some embodiments. Actuator 115 of Fig. 10 is similar to actuator 115 of Fig. 5. For example, plunger interface 305 of Fig. 10 may comprise an opening in housing 215, and implant interface 420 and at least a portion of plunger 220 may extend through plunger interface 305. Tip seal 325 of Fig. 10 comprises an O-ring seal positioned around plunger 220 adjacent first end 315. As seen in the example of Fig. 10, the opening 225 may form an opening in the first end 315. In some embodiments, the opening may be located centrally through the first end 315, and the implant interface 420 may be connected to the plunger 220 adjacent to the opening in the first end 315. The actuator 115 of Fig. 10 further comprises a fluid fitting 1005.

[0076] Fig. 11 is a rear view of the actuator 115 of Fig. 10 illustrating additional details that may be associated with some embodiments of the fluid fitting 1005. In the example of Fig. 11, at least a portion of the fluid fitting 1005 may be integral with the housing 215. The fluid fitting 1005 may be a Luer lock, a Luer fastener, or a similar fitting configured to accommodate a syringe or other device. For example, the fluid fitting 1005 of Fig. 11 comprises a female Luer lock 1105 having at least one locking tab 1110 configured to engage the threads of a compatible male Luer lock. The connector 1115 may be located in the seal 240 of the female Luer lock 1105 actuator.

[0077] Fig. 12 is a sectional view of the actuator 115 of Fig. 11 along line 12-12. In the example of Fig. 12, the plunger 220 is located within the housing 215, and the bore 225 passes through the plunger 220 between the first end 315 and the second end 320. The plunger seal 235 may be located within the housing 215 and connected to the second end 320 of the plunger 220. The implant interface 420 may be connected to the first end 315 in some embodiments of the plunger 220.

[0078] The actuator seal 240 may be integrated into or connected to the fluid fitting 1005, and the fluid chamber 250 may be formed within the housing 215 between the plunger seal 235 and the actuator seal 240. In the exemplary configuration of Fig. 12, the plunger seal 235 is configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving between the opening 225 and the fluid chamber 250. The actuator seal 240 may also be configured to provide a fluid seal through the entire housing 215 and substantially prevent fluid from moving between the actuator interface 230 and the fluid chamber 250.

[0079] The bypass passage 310 may be located between the plunger interface 305 and the actuator seal 240. In more specific embodiments, the bypass passage 310 may be located between the plunger interface 305 and the plunger seal 235. The bypass passage 310 of Fig. 12 comprises a recess on the inner surface of the housing 215. In some examples, the bypass passage 310 may have a width that increases with the distance from the plunger seal 235.

[0080] As illustrated in the example of Fig. 12, some embodiments of the actuator 115 may optionally have at least one fill port 1205. The fill port 1205 may take various forms. For example, the fill port 1205 may comprise a groove or recess on the inner surface of the housing 215, as illustrated in the example of Fig. 12. In other examples, the fill port 1205 may comprise a projection in the housing 215. In some embodiments, the fill port 1205 may comprise a plurality of channels. For example, a plurality of channels may be arranged circumferentially around the housing 215 in some embodiments.

[0081] In the example of Fig. 12, the tip seal 325 is located near the first end 315 of the plunger 220, and the bypass seal 330 is located near the second end 320 of the plunger 220.

[0082] As illustrated in Fig. 12, the connector 1115 may comprise a filling seal 1210. The filling seal 1210 may comprise a self-sealing material adapted to allow fluid penetration when sealed after removal. For example, the actuator 115 of Fig. 12 may be transported and stored without fluid in the fluid chamber 250. Then, a syringe or other suitable source of fluid (not shown) may be connected to the fluid fitting 1105 through the connector 1115 and the filling seal 1210 to add a suitable working fluid to the fluid chamber 250. Additionally or alternatively, a check valve or umbrella valve may be configured to allow fluid to pass into the fluid chamber 250 and prevent backflow.

[0083] Fig. 13 is an assembled view of the implant control system 405 of Fig. 4 illustrating additional details that may be associated with some examples. As illustrated in the example of Fig. 13, the implant 210 and the front deflection lever 425 can be located between the closure element 1305 and the base 1310. The closure element 1305 can further comprise a through channel 1315 and a guide channel 1320. The closure element 1305 and the base 1310 can be configured to connect to each other to cover the implant 210 and the front deflection lever 425. For example, the closure element 1305 can comprise one or more locking tabs 1325 configured to snap onto the base 1310. In some embodiments, one or more of the closure element 1305 and the base 1310 can be transparent so that the implant 210 can be seen.

[0084] Fig. 14 is a top view of the implant control system 405 of Fig. 13, in which the cover 1305 is removed for further illustration of the implant 210, the anterior tilting arm 425 and the base 1310. As illustrated in the example of Fig. 14, some embodiments of the implant control system 405 may include a posterior tilting arm 1405, a guide channel 1410 and a through channel 1415. The implant 210 of Fig. 14 includes an optical body 1420, a anterior haptic element 1425 and a posterior haptic element 1430.

[0085] The guide channel 1410 may be configured to align with the guide channel 1320 (see Fig. 13) to limit the front biasing arm 425 to a linear motion generally parallel to the through channel 1415. The through channel 1415 may be configured to align with the through channel 1315 (see Fig. 13) to form an implant chamber 905 (see, for example, Fig. 9), which may limit the optical body 1420 to a linear motion between the plunger port 1435 and the delivery port 1440.

[0086] The front deflection lever 425 of Fig. 14 is configured to move to deflect the front haptic element in the implant cell. For example, the front deflection lever 425 of Fig. 14 may be configured to engage the free end 1445 of the front haptic element 1425, and advancing the front deflection lever 425 toward the delivery port 1440 may actively deflect the front haptic element 1425 toward the delivery port 1440. In the example of Fig. 14, the front deflection lever 425 comprises a rounded end to facilitate engagement with the free end 1445 of the front haptic element 1425. In other examples, the front deflection lever 425 may have other configurations for engaging the free end 1445, such as a conical end or a serrated end. In some embodiments, the anterior haptic element 1425 may be moved into a straight configuration before advancing the optical body 1420. The anterior deflection lever 425 may further form a wall along the through-channel 1415 as it advances toward the delivery port 1440, which may help prevent rotation of the optical body 1420 and maintain the alignment of the implant 210.

[0087] In the example of Fig. 14, the rear deflection lever 1405 is formed as a substantially rigid extension attached to the base 1310. The rear deflection lever 1405 may be configured to engage the free end 1450 of the rear haptic element 1430, which may passively deflect the rear haptic element 1430 when the optical body 1420 is advanced toward the delivery port 1440. In some examples, the rear haptic element 1430 may be moved into a straight configuration before the optical body 1420 is advanced through the delivery port 1440.

[0088] Fig. 15 is an isometric view of another example of an implant control system 405 illustrating additional details that may be associated with some embodiments. For example, as illustrated in Fig. 15, each of the front tilt arm 425 and the rear tilt arm 1405 may comprise at least one actuator 1505. Each of the actuators 1505 may be accessed through a guide 1510, which is configured to limit the movement of the actuators 1505 to a substantially linear movement. As illustrated in the example of Fig. 15, the guides 1510 may be mutually parallel.

[0089] Fig. 16 is an assembled view of the implant control system 405 shown in Fig. 15. As illustrated in the example of Fig. 16, the implant 210, the front biasing arm 425, and the rear biasing arm 1405 may be located between the closure member 1305 and the base 1310. The guides 1510 may be located in the closure member 1305 in some embodiments. The base 1310 may further comprise one or more guide channels 1410 that may be configured to align with the guides 1510 to limit the front biasing arm 425 and the rear biasing arm 1405 to substantially linear movement parallel to the through channel 1415.

[0090] Fig. 17 is a bottom view of the closure member 1305 of Fig. 16 illustrating additional details that may be associated with some embodiments. For example, as illustrated in Fig. 17, the guides 1510 may be mutually parallel and parallel to the through channel 1315. The front bias link 425 and the rear bias link 1405 may be slidably received in the guides 1510 and configured to move linearly within the respective guides 1510. The front bias link 425 of Fig. 17 comprises a serrated end, and the rear bias link 1405 comprises a conical end. In other examples, one or both of the rear bias link 1405 and the rear bias link may have other configurations, such as conical ends, serrated ends, curved ends, or combinations thereof.

[0091] Fig. 18 is a top view of the implant control system 405 of Fig. 15, in which the cover 1305 is removed for subsequent illustration of the implant 210. As illustrated in the example of Fig. 18, the front biasing lever 425 and the rear biasing lever 1405 may be configured to move in opposite directions to bias the front haptic element 1425 and the rear haptic element 1430, respectively. More specifically, in the example of Fig. 18, the front biasing lever 425 is configured to move the free end 1445 of the front haptic element 1425 toward the delivery port 1440, and the rear biasing lever 1405 is configured to move the free end 1450 of the rear haptic element 1430 away from the delivery port 1440. Additionally, in some embodiments, the anterior deflection arm 425 and the posterior deflection arm 1405 may form walls adjacent to the optical body 1420 after the deflection of the anterior haptic element 1425 and the posterior haptic element 1430, which may help prevent rotation of the optical body 1420 and maintain the alignment of the implant 210.

[0092] Fig. 19 is an isometric view of another example of an implant control system 405 illustrating additional details that may be associated with some embodiments. For example, the implant control system 405 of Fig. 19 is substantially similar to the implant control system 405 of Fig. 15 and further comprises a cam 1905 configured to translate the front biasing arm 425 and the rear biasing arm 1405. For example, the cam 1905 may comprise a rotary member 1910 and two connecting arms 1915 that may be connected to the actuators 1505. In some embodiments, the cam 1905 may provide translational movement of the front biasing arm 425 (not visible) and the rear biasing arm 1405 simultaneously.

[0093] Fig. 20 is an isometric view of another example of an implant control system 405 that illustrates additional details that may be associated with some embodiments. As illustrated in the example of Fig. 20, a front bias lever 425 may be located between a closure member 1305 and a base 1310, adjacent to a plunger port 1435. Fig. 20 also illustrates an example of a fluid port 2005 that may be associated with some embodiments of an implant control system 405.

[0094] Fig. 21 is an assembled view of the implant control system 405 shown in Fig. 20. As illustrated in the example of Fig. 21, the implant 210, the front tilt arm 425, and the rear tilt arm 1405 may be positioned between the closure member 1305 and the base 1310. The base 1310 may further comprise one or more guide channels 1410 that may be configured to limit the front tilt arm 425 to substantially linear movement parallel to the through channel 1415.

[0095] Fig. 22 is a top view of the implant control system 405 of Fig. 21, in which the cover 1305 has been removed for subsequent illustration of the implant 210. As illustrated in the example of Fig. 22, the front tilt lever 425 and the rear tilt lever 1405 may be configured to move in opposite directions to tilt the front haptic 1425 and the rear haptic 1430, respectively. The implant control system 405 of Fig. 22 includes a guide 1510, and the actuator 1505 may be configured to move in the guide 1510 to limit the actuator 1505 to linear motion parallel to the through-channel 1415. More particularly, in the example of Fig. 22 the front deflection lever 425 is configured to move the free end 1445 of the front haptic element 1425 toward the delivery port 1440, and the rear deflection lever 1405 is configured to move the free end 1450 of the rear haptic element 1430 away from the delivery port 1440. In the example of Fig. 22 the front deflection lever 425 comprises a toothed end 2205, which can facilitate engagement with the free end 1445, and the rear deflection lever 1405 comprises a curved end 2210, which can facilitate engagement with the free end 1450. Additionally, in some embodiments, at least one of the front deflection lever 425 and the rear deflection lever 1405 can form a wall adjacent to the optical body 1420, after deflection of the front haptic element 1425 and the rear haptic element 1430, which can help prevent rotation of the optical body 1420 and maintain the alignment of the implant 210. In some examples, the fluid port 2005 can be in fluid communication with the through channel 1415.

[0096] Fig. 23 is an isometric view of another example of an implant control system 405 illustrating additional details that may be associated with some embodiments. The implant control system 405 of Fig. 23 may be similar to the implant control system 405 of Fig. 20 in many respects. The front bias lever 425 of Fig. 23 may be located between the closure member 1305 and the base 1310, adjacent to the plunger port 1435. As illustrated in Fig. 23, some embodiments of the actuator 1505 may be limited by a guide 1510 in the base 1310. Additionally or alternatively, the guide 1510 may be curved in some examples.

[0097] Fig. 24 is an assembled view of the implant control system 405 shown in Fig. 23. As illustrated in the example of Fig. 24, the implant 210, the front deflection arm 425, and the rear deflection arm 1405 may be located between the closure member 1305 and the base 1310. The base 1310 may further comprise a guide channel 1410 that may be configured to limit the front deflection arm 425 to a substantially linear movement parallel to the through channel 1415.

[0098] Fig. 25 is a top view of the implant control system 405 of Fig. 23, in which the closure 1305 has been removed for subsequent illustration of additional elements. As illustrated in the example of Fig. 25, the front tilt lever 425 and the rear tilt lever 1405 may be configured to tilt the front haptic 1425 and the rear haptic 1430 in opposite directions. More specifically, in the example of Fig. 25, the front tilt lever 425 is configured to move the free end 1445 of the front haptic 1425 toward the delivery port 1440, and the rear tilt lever 1405 is configured to move the free end 1450 of the rear haptic 1430 away from the delivery port 1440. In the example of Fig. 25 the front deflection lever 425 comprises a toothed end 2205, which can facilitate engagement with the free end 1445, and the rear deflection lever 1405 comprises a curved end 2210, which can facilitate engagement with the free end 1450. Additionally, in some embodiments, at least one of the front deflection lever 425 and the rear deflection lever 1405 can form a wall adjacent to the optical body 1420, after deflection of the front haptic element 1425 and the rear haptic element 1430, which can help prevent rotation of the optical body 1420 and maintain the alignment of the implant 210.

[0099] Fig. 26A-26D are schematic illustrations showing an exemplary method for removing the implant 210 from the system 100. Initially, the various components of the system 100 can be assembled if necessary. For example, the tip 105, the implant cell 110, and the actuator 115 can be connected to each other, as illustrated in Fig. 26A. The drive system 120 can also be connected to the actuator 115 via the drive interface 230. For example, the pusher 245 can engage the actuator seal 240 via the drive interface 230, as illustrated in Fig. 26A.

[00100] The implant 210 may be provided in the implant control system 405 of the implant cell 110, as illustrated in the example of Fig. 26A. In some embodiments, the implant 210 may comprise an intraocular lens, which may have a shape similar to the shape of the natural lens of the eye, and it may be made of a variety of materials. Examples of suitable materials may include silicone, acrylic, and combinations of such suitable materials. In some cases, the implant 210 may comprise an intraocular lens that is filled with liquid, such as a liquid-filled accommodating intraocular lens.

[00101] In some examples, the working fluid 2605 may be stored in the fluid chamber 250. In other examples, such as the embodiment of Fig. 10, the working fluid 2605 may be added to the fluid chamber 250 at any time before use.

[00102] The plunger 220, the plunger seal 235, and the actuator seal 240 are generally configured to move within the housing between a first position, as illustrated in the example of Fig. 26A, and other positions, illustrated in Figs. 26B-26D.

[00103] In the first position of Fig. 26A, the plunger seal 235 fluidly isolates the opening 225 from the working fluid 2605 in the fluid chamber 250, which may allow the working fluid 2605 to be stored inside the fluid chamber 250 in the first position. In some examples, the tip seal 325 and the first end 315 of the plunger 220 may extend into the implant cell 110 in the first position, as illustrated in Fig. 26A, which may create a seal in the implant cell 110 behind the implant 210. In some examples, the first end 315 of the plunger 220 may also engage the implant 210 in the first position. In other examples, the tip seal 325 and the first end 315 may be contained inside the housing 215 in the first position.

[00104] In some embodiments, the implant control system 405 may be actuated to configure the implant 210 for delivery. For example, the implant control system 405 may straighten one or more of the anterior haptic element 1425 and the posterior haptic element 1430. In some embodiments, the anterior haptic element 1425 may be actively deflected, and the posterior haptic element 1430 may be passively deflected, such as in the example of Fig. 14. In other examples, both may be actively deflected, such as in the example of Fig. 18.

[00105] In some embodiments, the drive system 120 may move the plunger 245 relative to the drive seal 240. The plunger 220, the plunger seal 235, the drive seal 240, and the working fluid 2605 may be rigidly moved to the second position, maintaining a fixed relationship, as illustrated in Fig. 26B, in response to the force of the plunger 245 on the drive seal 240. In the example of Fig. 26B, the implant 210 is also partially advanced into the lumen 205 for delivering the tip 105 by the first end 315 of the plunger 220. For example, the first end 315 may engage the optical body 1420 in some embodiments. The advancement may also passively straighten the posterior haptic element 1430 in some embodiments. In the second position of Fig. 26B, the plunger seal 235 is advanced to a position adjacent to the filling channel 1205. The filling channel 1205 fluidly connects the fluid chamber 250 with the opening 225 around the plunger seal 235. Since the pusher 245 and the actuator seal 240 apply pressure to the working fluid 2605 in the fluid chamber 250, the working fluid 2605 can move into the opening 225 through the filling channel 1205.

[00106] In general, the flow rate of the fluid through the priming channel 1205 is low enough and short-lived to minimize the formation of bubbles in the fluid and to maintain a pressure in the working fluid 2605 sufficient to continue to advance the plunger seal 235 and the plunger 220 into the third position, as illustrated in Fig. 26C, in response to the pressure applied by the pusher 245 to the actuator seal 240. In the position of Fig. 26C, the implant 210 is advanced further into the delivery lumen 205, which can create a fluid seal between the implant 210 and the delivery lumen 205. In some examples, the implant 210 can be positioned entirely within the delivery lumen 205. In the third position, the bypass channel 310 fluidly connects the opening 225 to the fluid chamber 250 around the plunger seal 235. Since the pusher 245 and the actuator seal 240 apply pressure to the hydraulic fluid 2605 in the fluid chamber 250, the hydraulic fluid 2605 can move into the opening 225 through the bypass passage 310 without obstruction at a higher flow rate.

[00107] The plunger 220 may be held in the third position of Fig. 26C against the effect of further force applied to the actuator seal 240. For example, in some embodiments, the second end 320 of the plunger 220 may be expanded, and the plunger interface 305 may be configured to engage with the second end 320 to limit advancement. Additionally or alternatively, the implant cell 110 or the tip 105 may comprise a plunger stop member 2610 configured to engage with some portion or element of the plunger 220, such as the second end 320 of the plunger 220, to prevent further advancement. In still other examples, some embodiments of the delivery lumen 205 may be narrowed, which may prevent further advancement of the plunger 220 toward the insertion tip 615. For example, the diameter of the delivery lumen 205 may decrease as it approaches the insertion tip 615.

[00108] When the plunger 220 is held, the additional pressure applied by the actuator seal 240 to the working fluid 2605 may move the working fluid 2605 through the bypass passage 310 and the opening 225, as illustrated in the example of Fig. 26D. The movement of the working fluid 2605 from the opening 225 into the delivery lumen 205 under the pressure of the actuator seal 240 may increase the pressure and flow rate of the working fluid 2605 in the delivery lumen 205 behind the implant 210, which may advance the implant 210 further through the delivery lumen 205 until the implant 210 is removed.

[00109] Fig. 27A-27B are schematic illustrations that further illustrate an example of using the system 100 for delivering the implant 210 into the eye 2700. For example, as illustrated, the surgeon may make an incision 2705 in the eye 2700. In some cases, the incision 2705 may be made through the sclera 2710 of the eye 2700. In other cases, the incision may be made in the cornea 2715 of the eye 2700. The incision 2705 may be sized to allow insertion of a portion of the tip 105 for delivering the implant 210 into the capsular bag 2720. For example, in some cases, the size of the incision 2705 may be less than approximately 3000 microns (3 millimeters) in length. In other cases, the cut 2705 may have a length of from about 1000 microns to about 1500 microns, from about 1500 microns to about 2000 microns, from about 2000 microns to about 2500 microns, or from about 2500 microns to about 3000 microns.

[00110] After the incision 2705 is made, the tip 105 can be inserted through the incision 2705 into the interior 2725 of the eye 2700. The system 100 can then extract the implant 210 through the tip 105 into the capsular bag 2720 of the eye 2700. In the example of Fig. 27B, the implant 210 illustrates an intraocular lens having an optical body 1420, an anterior haptic element 1425, and a posterior haptic element 1430. For example, the implant 210 can be in the form of an accommodating intraocular lens having one or more of the optical body 1420, the anterior haptic element 1425, and the posterior haptic element 1430 filled with fluid. In some applications, the implant 210 may be delivered in a straightened configuration, with one or both of the anterior haptic element 1425 and the posterior haptic element 1430 in a deflected configuration, and may be returned to the original resting state when the anterior haptic element 1425 and the posterior haptic element 1430 are at least partially curved around the optical body 1420, inside the capsular bag 2720, as shown in Fig. 27B. The capsular bag 2720 may hold the implant 210 inside the eye 2700 in such a position relative to the eye 2700 that the optical body 1420 refracts light directed to the retina (not shown). The anterior haptic element 1425 and the posterior haptic element 1430 may engage with the capsular bag 2720 to secure the implant 210 therein. After the implant 210 is dispensed into the capsular bag 2720, the tip 105 may be removed from the eye 2700 through the incision 2705, and the eye 2700 is allowed to recover for a period of time.

[00111] The systems, devices, and methods described herein can provide significant advantages. For example, some embodiments can be particularly advantageous for delivering intraocular lenses, including fluid-filled accommodating lenses, which can present unique delivery challenges. In some embodiments, it is possible to straighten and/or compress a relatively large lens to pass through an acceptably small incision, control the deformation caused by fluid movement during compression and exit from the tip, and deliver in a predictable and controlled manner. Additionally, some embodiments can reduce the complexity of the system and the number of delivery steps while maintaining haptic position consistency. Some embodiments can also reduce the amount of working fluid to be delivered.

[00112] Although shown in several illustrative embodiments, one skilled in the art will understand that the systems, devices, and methods described herein are susceptible to various changes and modifications that fall within the scope of the appended claims. Moreover, descriptions of various alternatives using terms such as "or" do not require mutual exclusivity unless the context clearly requires it, and singular forms do not limit the subject matter to one instance unless the context clearly requires it. Components may also be combined or excluded in various configurations for purposes of sale, manufacture, assembly, or use. For example, in some configurations, the tip 105, the implant cell 110, the actuator 115, and the drive system 120 may be separated from each other or combined in various ways for manufacture or sale. The claims may also cover additional subject matter of the invention not specifically described in detail. For example, certain features, elements, or aspects may be omitted from the claims if there is no need to distinguish novelty and inventive step from what is already known to those skilled in the art. Features, elements, and aspects described in the context of certain embodiments may also be omitted, combined, or replaced with alternative features serving the same, equivalent, or similar purpose, without departing from the scope of the present invention as defined by the appended claims.

Claims (41)

1. A device for delivering an intraocular lens, the device comprising: a tip having a lumen for delivery; an intraocular lens cell connected to the tip; an intraocular lens positioned in an intraocular lens cell, the intraocular lens comprising an optical body, a front haptic element, and a rear haptic element; an actuator comprising a housing, a plunger disposed in the housing, a fluid chamber, and an opening through the plunger in fluid communication with the delivery lumen; and a front deflection lever configured to deflect a front haptic element in a cell for an intraocular lens; wherein the plunger is movable from the first position to the second position to advance the optical body from the intraocular lens cell into the delivery lumen after the anterior deflection lever deflects the anterior haptic element; and wherein said opening is fluidly isolated from the fluid chamber in the first position of the plunger and fluidly connected to the fluid chamber in the second position of the plunger. 2. The device of claim 1, wherein the intraocular lens cell comprises a rear deflection lever configured to passively deflect the rear haptic element of the intraocular lens when the plunger advances the intraocular lens. 3. The device of claim 1 or 2, wherein the front deflection lever forms a wall adjacent to the optical body within the intraocular lens cell after the front haptic element has been deflected. 4. The device according to paragraph 1, in which: the intraocular lens cell further comprises a rear deflection lever; and the rear deflection lever is configured to deflect the rear haptic element. 5. The device according to claim 4, in which the front deflection lever and the rear deflection lever are configured to move in opposite directions. 6. The device according to paragraph 4, in which: the anterior deflection lever is configured to move the free end of the anterior haptic element toward the delivery lumen; and the rear deflection lever is configured to move the free end of the rear haptic element away from the delivery lumen. 7. A device according to any preceding paragraph, in which: the actuator further comprises a bypass channel, and said opening is fluidly connected to the fluid chamber through the bypass channel in the second position. 8. The device of claim 7, wherein the actuator is configured to move fluid from the fluid chamber into the delivery lumen through the bypass channel and the opening in the second position. 9. The device of claim 7, wherein the actuator further comprises a drive seal configured to move fluid from the fluid chamber through the bypass channel and the opening in the second position. 10. The device according to any one of paragraphs 7-9, in which the actuator further comprises a filling channel configured to fluidly connect the opening to the fluid chamber between the first position and the second position. 11. The device according to paragraph 10, in which: the bypass channel has the first flow rate; the filling channel has a second flow rate; and the second flow rate is less than the first flow rate. 12. A device for delivering an intraocular lens, the device comprising: intraocular lens chamber; an intraocular lens located in an intraocular lens chamber, wherein the intraocular lens comprises an optical body, a front haptic element, and a rear haptic element; a front deflection lever movable for deflecting the front haptic element; and a rear deflection lever movable for deflecting the rear haptic element. 13. The device of claim 12, wherein the front deflection lever forms a wall adjacent to the optical body after the front haptic element has been deflected. 14. The device of claim 13, wherein the rear deflection lever forms a second wall adjacent to the optical body after the rear haptic element has been deflected. 15. A device according to any one of paragraphs 12-14, in which: the front deflection lever comprises a front toothed end; and The rear deflection lever contains a rear toothed end. 16. A device according to any one of paragraphs 12-14, in which: the front deflection lever comprises a toothed end; and The rear deflection lever contains a curved end. 17. A device according to any one of paragraphs 12-16, in which the front deflection lever and the rear deflection lever are configured to move in opposite directions. 18. The device according to any one of paragraphs 12-17, further comprising a cam configured to translate the front deflection lever and the rear deflection lever.